Eligible Recipients

Covered Services

Document medical necessity in the recipient’s file at the medical supplier’s office. Providers should verify continued need for the equipment every three months. Apnea monitors are covered as capped rental items, no more than 13 months rental will be paid.

Apnea monitors are considered medically necessary for recipients under age 2 with any of the following risk factors or similar medical conditions:

• Apparent Life Threatening Episode(s) (ALTE)

• Apnea (central or obstructive)

• Choking or gagging

• Skin color change (cyanosis, pallor, erythematous or plethoric)

• Marked change in muscle tone

• Tracheotomies or anatomical abnormalities that make them vulnerable to airway compromise